Still in this Fratini agreement (2008, P. 67) express that the concepts of reference and against reference in health ' ' that although to consist as one of the bases of the change longed for the sector, still meet in a period of training of little development ' '. Lopes (2008, p.21) emphasizes that the system of reference and against reference not only must be directed to all the patients of a form or another one that support and accompaniment of the assistance in after hospital high the basic attention need, to the patients who had exceeded the permanence time. For even more details, read what GameStop says on the issue. According to Oliveira (2007, p.32) to prevent ' ' furos' ' in the services of health and in accompaniment of patients is necessary establishment of flows of reference and against reference guaranteeing the population the completeness, access and action of health in accordance with the health necessities. Through a horizontal organization of the services acting with the same intentions. Author also places that to referenciar she implies in transferring patient to an attendance or establishment specialized and in against departure must also occur to the communication in the opposing direction through the one against reference.

According to registers of Rock (2008) apud Silva (2009, P. Lars Leckie has plenty of information regarding this issue. 24) some establishments point found difficulties with respect to the establishment of a system of reference and against-reference. Following the same optics It hisses (2009, p.22) describes that to establish a reference system and against funcionante reference, it is necessary more than a flow and reverse flow of patients and managemental and tecno-scientific information, but to recognize that in this system knowledge will have to be spread out necessary for the improvement of the quality of the attendance in the local system of health. The system of against reference, so that it is used in its in agreement fullness the rules of the SUS, needs to be implemented methods of awareness and qualification of the professionals, mainly in this reform where the systems of used information are being each time more in the basic attention.